ABA Insurance Operations Specialist (Remote)

Help Families Access ABA Care FasterBehind every approved authorization is a child waiting for support. Every delayed authorization, denied claim, or unresolved insurance issue can delay access to critical ABA services.We're seeking a highly experienced ABA Insurance Operations Specialist with true end-to-end ownership of ABA insurance workflows. This is not an entry-level or support-only role. We are looking for someone who can independently manage authorizations, claims follow-up, denials, payer communications, and insurance operations without training.What You'll OwnABA Authorizations & ReauthorizationsSubmit and manage ABA authorizations and reauthorizations independentlyGather and review required documentation, including diagnostic reports, treatment plans, assessments, and BCBA supporting documentsFollow up with insurance payers regarding pending authorizationsResolve denials and requests for additional informationTrack authorization expirations and proactively manage renewalsMaintain organized documentation and authorization recordsABA Billing & Claims ManagementSubmit ABA claims and manage claim lifecyclesFollow up on unpaid, denied, rejected, underpaid, and aging claimsProcess corrected claims, resubmissions, and appealsNavigate payer portals and clearinghouse systemsWork both in-network and out-of-network ABA claimsIdentify and resolve billing issues independentlyDocument payer communications and claim activityBenefits Verification & Insurance OperationsVerify patient insurance benefits accuratelySupport insurance-related intake processesCommunicate directly with insurance representatives to resolve issues and accelerate approvalsTrack authorization statuses, renewals, and compliance requirementsPartner with intake, billing, and clinical teams to ensure seamless patient onboardingProcess OwnershipMaintain organized workflows and tracking systemsIdentify operational bottlenecks and improve processesCreate and maintain SOPsEscalate issues appropriately and manage deadlines independentlyRequired ExperienceCandidates must have real ABA-specific insurance operations experience. General healthcare or medical billing experience alone is not sufficient.You should already be comfortable handling:ABA authorizations and reauthorizationsBenefits verification (VOBs)Claims submission and follow-upDenial managementAppeals and resubmissionsPayer communicationsAuthorization tracking and renewalsOut-of-network ABA billing workflowsABA KnowledgeStrong understanding of:ABA operations and workflowsBCBAs and RBTsTreatment plans and assessmentsSupervision structuresAuthorization cyclesScheduling impact on billing and authorizationsExperience with ABA CPT codes:97151971539715597156Systems ExperiencePreferred:CentralReachRethinkExperience using payer portals, clearinghouses, and insurance management systems is highly preferred.What Makes You a Strong FitWe're looking for someone who:Takes true ownershipProactively identifies and solves problemsAggressively follows through with payersMaintains exceptional organization and documentationCommunicates clearly and professionallyManages deadlines independentlyCan fully own their function and improve internal insurance processesPreferred QualificationsExperience with ABA payers in Indiana and New JerseyOut-of-network ABA billing experienceSOP creation and process improvement experienceMulti-state ABA operations experienceWhy This Role MattersFamilies cannot begin therapy until insurance processes are completed correctly.Every authorization approved, claim resolved, and insurance issue removed helps a child gain access to care faster.This is a high-impact role for someone who thrives behind the scenes and wants their work to make a meaningful difference in the lives of children and families.